Sanitation and hygiene practices among primary school learners in Ngamiland district, Botswana

Improved sanitation and personal hygienic practices are considered important towards reducing the risks of spreading communicable diseases and improving public health. Diarrheal related deaths amongst adolescents are reported to be amongst the top ten for the age groups 10-19 year olds and second among the age group 10-14 year olds globally. Primary school learners in developing countries are among the most vulnerable sub-population. These mortalities and illnesses can be reduced by addressing personal hygiene among school children and simultaneously promoting better school attendance and improved learning. In order to facilitate improved health and educational outcomes, it is necessary therefore to effectively address water, sanitation and hygiene matters within the school environment. This study explored hygiene education, personal hygiene practices among learners, environmental sanitation and hygiene within three primary schools in the Ngamiland district, Botswana. From the three schools, a total sample of 285 pupils was selected using proportionate stratified random sampling technique, and 15 teachers purposively selected as key informants. Data was collected using semi-structured questionnaires with key informants and social survey instrument for learners. Results show that very few learners linked poor hygiene to the following diseases; diarrhea/upset stomach (31.7%); malaria (23%); bilharzia (16.4%), and cholera (14.8%), demonstrating low hygiene knowledge. Hygiene education in schools is infused in the curriculum, and teacher training on hygiene education is only through in-service training workshops. Regarding personal hygiene practices, over 70% of the learners indicated that they 'always' wash their hands before and after eating, with slightly over one-fifth indicating 'sometimes'. Overwhelming majority of learners dispose solid waste in dustbins (99.3%, n = 284), use refuse bags (80.8%, n = 231), open skips (64%, n = 183) and very few throw trash anywhere either on the school compound or classroom (9.1%, n = 26 and 8.7%, n = 25 respectively). The current low levels of hygiene knowledge among learners in the study area has potential to affect learners' performance at school as risky hygiene practices make them vulnerable to contracting infectious diseases and missing school. This prompts the need to think beyond the infusion approach used in schools. Extra-curricular clubs in schools should be established to promote pro-hygiene behaviors and to facilitate adolescence meaningful and sustained participation.